Unintentional falls are one of the major health risks for adults over 65 years of age. Every year one-third of older adults, 65+ years, fall. Falls are indeed the leading cause of injury death in older adults. In 2008 alone, 19,700 people died because of injuries resulting from unintentional falls. And while some falls may only lead to moderate to severe non-life threatening injuries, the psychological effect of falls is also severe. Some studies estimated the number of unintentional falls in 2009 at 2.2 million. Five hundred eighty-one thousand of these falls resulted in hospitalization. People who have fallen once often develop a fear of falling again. This fear leads them to limit their day-to-day activities, which further leads to reduced mobility resulting in deteriorating physical fitness level. This in turn puts them at an even greater risk of falling [1].
Falls (fatal and non-fatal) can be very costly for the health care system. According to the numbers reported by CDC, falls among older adults in 2000 cost the U.S. healthcare system over $19 billion [1]. According to another study the cost of fatal fall related injuries in 2005 totaled around $349 million: $160 million for men and $189 million for women [2]. There is a direct cost related to falls which accounts for what insurance companies, patients, and health care system pays for treating fall related fracture/injuries etc., and there is an indirect cost which represents the follow-up long term cost of care. Cost of hospital care following an injurious fall among the elderly is also higher at $6.5 billion as estimated in 2006 by one study [2]. It's estimated that by 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion [1].
Because falls are a high risk for patients due to diminished lifestyle, and health care payers due to monetary implications, it is in the best interest of both parties to reduce unintentional falls. However, reducing the number of falls is difficult. Unlike severe medical conditions such as cancer etc., a fall is not a single medical condition and as such, does not have a set definition. The current definition of a fall that is widely used is “unintentionally coming to rest on the ground, floor or other lower level.” Falls result due to multiple medical conditions that a patient may have or medications that they may be taking. Most of the current efforts directed toward reducing falls consist of questionnaires given to patients at physician visits and deciding the risk of fall for patients based on these questions. Because there is no set definition of a fall, there is also no set “rule of thumb” questionnaire that could be used as a baseline for predicting the risk of falls for a patient. Multiple studies in the past have shown various medical conditions and medications that are connected to falls like fracture, injuries, difficulty walking, breathing problems, high risk medications such as benzodiazepines [3], [4].
Although the questionnaire based methods are widely used to ascertain the risk of falling for a member, there is no automated “proactive” system that could notify the health care provider or physician about the risk of falls for a person. Patients as well as health care providers and payers can all benefit from such a system because it would reduce expenditure for avoidable injuries and lead to a better lifestyle for the patient. There is a need for an automated falls prediction system and method that can identify the falls risk (probability of fall) for each patient and further direct them to the proper course of intervention.